I would like to ask opinions. I want new implants. Mine have lost volume and rippled due to weight loss. (Photo)
Doctor Answers 13
I would like to ask opinions. I want new implants. Mine have lost volume and rippled due to weight loss.
Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "up a cup size” or "DD cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.
I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.
Redo breasts augmentation with mini lift
Thanks for submitting your pictures. From the pictures, you appear to be full C cup size with level 2 ptosis(droopiness) and very large areolas.
You did not provide info on the pocket location. As a rule, sub muscular pocket is a much better option because of the better coverage. If you have sub glandular pocket, it can be converted to sub muscular.
To become much larger, say, 32 DD, you will have to replace your present implants with volume that is bigger by 325 cc than your current implants size.
I would strongly recommend a mini lift (donut) procedure at the same time, which will give you beautiful, perky and youthful breasts with more attractive areolas. Without the mini lift, in order to give you a nipple lift, the IMF (infra mammary fold ) will have to be lowered significantly, lowering your breasts position on the chest even further than the present low position which is not attractive and looks old.
You will have, most likely, to have capsulotomy (scar release), in order to enlarge the pocket and suit the larger implants, and give your breasts a more natural look.
Always , consult with experienced board certified plastic surgeons who perform lots of redo breasts augmentation surgeries in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive.
Best of luck,
With a larger implant you should not need a lift. Be sure to consult with a certified plastic surgeon to discuss your options and expectations, such as areolar widening and aging of large implants. Good luck!
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Capsulectomy and implant replacement
A lift with an implant is controversial for two reasons. First, when you perform a lift you are making everything tight and closing the wounds under tension. It you add the expansive forces of the implant at the same time, you are fighting against yourself. There are forces on the wound which try to make them separate, which results in wider, thicker, more irregular scars. In the worst case, the wounds will open. So compromises are usually made in the operating room by the surgeon because they cannot close the lift wounds over the appropriate sized implant. Either less of a lift is performed so that the skin is not as tight and therefore there is less tension on the closure. Or a smaller implant than would be appropriate is used so as to decrease the expansive forces. Either way, you are compromising the aesthetic outcome. Often the outcome is so compromised that a second revision surgery is required. If however, you plan to have the lift first and then the augmentation after everything has healed, then you have two operation that are planned, both with much lower risk than the combined mastopexy/augmenation. The outcomes of the two meticulously planned operations are much better and a more aesthetically pleasing, and a safer outcome is achieved.
The second reason the combination of mastopexy and augmentation is controversial is because of the risk of nipple necrosis (death of the nipple). By making the skin tight for the lift, you are putting external pressure on the veins that supply the nipple. By putting an expansive force on the undersurface of the breast with an implant, you are putting pressure on the thin walled veins that supply the nipple. If the pressure by squeezing the veins between the implant and the skin is greater than the venous pressure in the veins, the flow will stop. If the venous outflow stops, the arterial inflow is stopped. If the arterial inflow is stopped, there is no oxygen for the healing wounds and the tissue dies.
Placing the implant on top of the muscle in combination with a lift puts the blood supply to the nipple at a much higher risk because in addition to the issue of pressure on the veins, you have to divide the blood vessels that are traveling from the pectoralis muscle directly into the breast (and to the nipple) in order to place the implant between the breast tissue and the muscle. This adds a third element of risk to an already risky operation. Mastopexy/augmenation with sub glandular implant placement is by far the riskiest way to address your anatomic question.
A lift is a good option
I want new implants. Mine have lost volume and rippled due to weight loss.
Just a word of caution. The larger the implant, the heavier it is, the sooner they will sag. I suggest you have them placed behind the muscle to give them much needed support. You will need a lift in order to achieve long term results. Do not allow someone to just replace them with larger implants without doing a lift of some sort. You won't be happy with the outcome.
I hope this helps.
Best wishes and kind regards,
Weight loss and change in appearance of breasts
Do I need a lift?
Breast Augmentation - Implant Exchange
The decision on whether or not to have a breast lift can be challenging as many women do not want to add visible scarring to their breasts. However, you need to decide what is more important to you - breast shape or the scarring. If you desire very high, rounded, "fake looking" breasts, then you will benefit from a lift and implant exchange. Also, your pictures make me wonder if your implants are above your muscle and if they are not you might benefit from a submuscular conversion. If you are happy with your current implant location, then larger implants will help round out your breasts and this can most likely be performed through the same scar that you already have. Without a breast lift though, your implants will stay in the same relative position as to where they are now. If you are desiring a lot of cleavage or more elevated, rounded breasts then you will probably be happiest with a breast lift. A breast lift does add scars but more people find if reasonable trade off for the improved shape.
Jennifer Boll, MD
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.